Individual provider Active NPI

Jenna Gaw, DDS

  • Endodontics
  • Schaumburg, IL
National Provider Identifier
1003223660
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
19032497 Issued in IL
Practice address
808 E Woodfield Rd Ste 300
Schaumburg, IL 60173-4836
Phone
(925) 285-2411
NPI assigned
Jul 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN4391 ME
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 004031 OH
Endodontics 1223E0200X 19032497 IL Primary

Addresses

Primary practice location

808 E Woodfield Rd Ste 300
Schaumburg, IL 60173-4836

Mailing address

1724 Locust PL Apt 303
Schaumburg, IL 60173-4239
Phone (925) 285-2411

Other practice location 1

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (925) 285-2411

Other practice location 2

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (925) 285-2411

Other practice location 3

220 Alamo Plz
Alamo, CA 94507
Phone (925) 285-2411

Other practice location 4

2124 Cornell Rd # Doa31A
Cleveland, OH 44106
Phone (925) 285-2411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19032497ILMDEndodontist
004031OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Jenna Gaw, DDS, PLLC Endodontics Current Accepting new patients
Jenna Gaw, DDS, PLLC CurrentSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1003223660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 LOCUST PL APT 303",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734239",
            "telephone_number": "925-285-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 E WOODFIELD RD STE 300",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734836",
            "telephone_number": "925-285-2411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "925-285-2411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "925-285-2411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Alamo Plz",
            "address_purpose": "LOCATION",
            "city": "Alamo",
            "state": "CA",
            "postal_code": "94507",
            "country_code": "US",
            "telephone_number": "925-285-2411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2124 Cornell Rd # Doa31A",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "44106",
            "country_code": "US",
            "telephone_number": "925-285-2411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAW",
        "first_name": "JENNA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "DEN4391",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "004031",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "19032497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.